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The Counselor Trainee Extension Form from the Ohio Counselor, Social Worker & Marriage and Family Therapist Board is designed for counselor trainees needing to extend their period of training. It serves to gather essential information about the trainee's educational and professional background, including any changes in supervision or work site. The form ensures that trainees continue to meet the regulatory standards set forth by the board and maintain eligibility for training under supervision.
Completing the form involves several detailed steps, crucial to ensuring that all required information is accurately captured:
Personal Information: Begin by providing your full name, contact details, and license number.
Supervision Changes: If there have been any changes to your supervision, detail the new supervisor's name, license number, and the date of change.
Work Duties and Location: Indicate any adjustments in your duties or practice site. Include the address of the new location if applicable.
Disclosure Section: Report any legal issues or substance abuse incidents that may affect your professional practice. Provide pertinent details or documentation if necessary.
Supervisor's Confirmation: The supervising professional must fill out their section to confirm your qualifications and the nature of your duties under their supervision.
Signature: Sign and date the form to validate the information provided.
This form is vital for maintaining the integrity of the counseling profession within Ohio. It ensures that counselor trainees continue to operate under proper supervision and adhere to ethical and legal standards. Moreover, it serves as a regulatory compliance document, aligning with the board's mandate to oversee the professional conduct and qualifications of trainees.
Primarily, this form is utilized by counselor trainees in Ohio who seek to extend their training period beyond the standard duration. It is also essential for current supervisors who need to report any changes in the trainee's responsibilities or professional setting. Licensing authorities also use this form to monitor and verify ongoing training compliance.
Before submitting the form, ensure you have the following documents ready:
The form can be submitted through various channels:
The form comprises several critical sections that require detailed attention:
To be eligible for using this form, applicants must meet specific criteria:


Failure to submit an accurately completed form or withholding pertinent information can lead to serious consequences:
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2014 | 4 Satisfied (53 Votes) |
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